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Meta-Analysis
. 2004;2002(3):CD003642.
doi: 10.1002/14651858.CD003642.pub2.

Chinese herbal medicines for type 2 diabetes mellitus

J P Liu  1 , M Zhang, W Y Wang, S Grimsgaard
Affiliations
Meta-Analysis

Chinese herbal medicines for type 2 diabetes mellitus

J P Liu et al. Cochrane Database Syst Rev. 2004.

Abstract

Background: Traditional Chinese herbal medicines have been used for a long time to treat diabetes, and many controlled trials have been done to investigate their efficacy.

Objectives: To assess the effects of Chinese herbal medicines in patients with type 2 diabetes mellitus.

Search strategy: We searched the following electronic databases: The Cochrane Library (CENTRAL), the Chinese BioMedical Database, MEDLINE, EMBASE, and LILACS, combined with hand searches on Chinese journals and conference proceedings. Date of last search was April 2004. No language restriction was used.

Selection criteria: Randomised trials of herbal medicines (with at least two months treatment duration) compared with placebo, pharmacological or non-pharmacological interventions were included.

Data collection and analysis: Data were extracted independently by two reviewers. The methodological quality of trials was evaluated using the parameters of randomisation, allocation concealment, double blinding, and drop-out rates. Meta-analyses were performed where data were available.

Main results: Sixty-six randomised trials, involving 8302 participants, met the inclusion criteria. Methodological quality was generally low. Sixty-nine different herbal medicines were tested in the included trials, which compared herbal medicines with placebo, hypoglycaemic drugs, or herbal medicines plus hypoglycaemic drugs. Compared with placebo, Holy basil leaves, Xianzhen Pian, Qidan Tongmai, traditional Chinese formulae (TCT), Huoxue Jiangtang Pingzhi, and Inolter showed significantly hypoglycaemic response. Compared with hypoglycaemic drugs including glibenclamide, tolbutamide, or gliclazide, seven herbal medicines demonstrated a significant better metabolic control, including Bushen Jiangtang Tang, Composite Trichosanthis, Jiangtang Kang, Ketang Ling, Shenqi Jiangtang Yin, Xiaoke Tang, and Yishen Huoxue Tiaogan. In 29 trials that evaluated herbal medicines combined with hypoglycaemic drugs, 15 different herbal preparations showed additional better effects than hypoglycaemic drugs monotherapy. Two herbal therapies combined with diet and behaviour change showed better hypoglycaemic effects than diet and behaviour change alone. No serious adverse effects from the herbal medicines were reported.

Reviewers' conclusions: Some herbal medicines show hypoglycaemic effects in type 2 diabetes. However, these findings should be carefully interpreted due to the low methodological quality, small sample size, and limited number of trials. In the light of some positive findings, some herbal medicines deserve further examination in high-quality trials.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1.1
1.1. Analysis
Comparison 1 Herbal medicine versus placebo, Outcome 1 Normalisation of fasting blood glucose (< 7.2 mmol/L).
1.2
1.2. Analysis
Comparison 1 Herbal medicine versus placebo, Outcome 2 Fasting blood glucose levels (mmol/L).
1.3
1.3. Analysis
Comparison 1 Herbal medicine versus placebo, Outcome 3 Glycated haemoglobin levels (%).
1.4
1.4. Analysis
Comparison 1 Herbal medicine versus placebo, Outcome 4 Fasting serum insulin levels (mU/L).
2.1
2.1. Analysis
Comparison 2 Herbal medicines versus hypoglycemic drugs, Outcome 1 Normalisation of fasting blood glucose levels (< 7.2 mmol/L).
2.2
2.2. Analysis
Comparison 2 Herbal medicines versus hypoglycemic drugs, Outcome 2 Fasting blood glucose levels (mmol/L).
2.3
2.3. Analysis
Comparison 2 Herbal medicines versus hypoglycemic drugs, Outcome 3 Glycated haemoglobin levels (%).
2.4
2.4. Analysis
Comparison 2 Herbal medicines versus hypoglycemic drugs, Outcome 4 Fasting serum insulin levels (mU/L).
3.1
3.1. Analysis
Comparison 3 Herbal medicine plus hypoglycaemic drug versus hypoglycaemic drug, Outcome 1 Normisation of fasting blood glucose levels (< 7.2 mmol/L).
3.2
3.2. Analysis
Comparison 3 Herbal medicine plus hypoglycaemic drug versus hypoglycaemic drug, Outcome 2 Fasting blood glucose levels (mmol/L).
3.3
3.3. Analysis
Comparison 3 Herbal medicine plus hypoglycaemic drug versus hypoglycaemic drug, Outcome 3 Glycated haemoglobin levels (%).
3.4
3.4. Analysis
Comparison 3 Herbal medicine plus hypoglycaemic drug versus hypoglycaemic drug, Outcome 4 Fasting serum insulin levels (mU/L).
4.1
4.1. Analysis
Comparison 4 Herbal medicine plus dietary and lifestyle modification versus dietary and lifestyle modification, Outcome 1 Normalisation of fasting blood glucose levels (< 7.2 mmol/L).
4.2
4.2. Analysis
Comparison 4 Herbal medicine plus dietary and lifestyle modification versus dietary and lifestyle modification, Outcome 2 Fasting blood glucose levels (mmol/L).
4.3
4.3. Analysis
Comparison 4 Herbal medicine plus dietary and lifestyle modification versus dietary and lifestyle modification, Outcome 3 Glycated haemoglobin levels (%).
4.4
4.4. Analysis
Comparison 4 Herbal medicine plus dietary and lifestyle modification versus dietary and lifestyle modification, Outcome 4 Fasting serum insulin levels (mU/L).
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References

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    1. Huang JY, Huang L. [Treating 50 cases of type 2 diabetes mellitus by combined TCM and western medicine] [in Chinese]. Hunan Guiding Journal of Traditional Chinese Medicine and Pharmacology 2002;8(8):481‐4.
Huang Q 2003 {published data only}
    1. Huang Q, Ni HX, Shao GM. [Effect of Chinese herbal medicine for activating blood circulation to remove stasis on CD11b/CD18 expression in patients with diabetes mellitus type 2] [in Chinese]. Chinese Journal of Integrated Traditional and Western Medicine 2003;23(6):430‐2. - PubMed
Huang SM 1997 {published data only}
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Jiang ZS 1997 {published data only}
    1. Jiang ZS, Zhang SL, Cai XJ, Xing WJ, Wang SX. [Effect of Salvia miltiorrhiza composita on superoxide dismutase and malonyldialdehyde in treating patients with non‐insulin dependent diabetes mellitus (NIDDM)] [in Chinese]. Chinese Journal of Integrated Traditional and Western Medicine 1997;17(1):32‐4. [MEDLINE: ] - PubMed
Jiao YX 2003 {published data only}
    1. Jiao YX, Dong XR, Jiang Q. [Clinical observation on Xihuang Jiangtang capsule for treating 87 cases of type 2 diabetes] [in Chinese]. Acta Chinese Medicine and Pharmacology 2003;31(4):41.
Khan 1979 {published data only}
    1. Azad Khan AK, Akhtar S, Mahtab H. Coccinia indica in the treatment of patients with diabetes mellitus. Bangladesh Medical Research Council Bulletin 1979;5(2):60‐6. - PubMed
Lan QF 2000b {published data only}
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Lang J 1998 {published data only}
    1. Lang J, Cao H, Wei A. [Comparative study on effect of Panax notoginseng and ticlid in treating early diabetic nephropathy] [in Chinese]. Chinese Journal of Integrated Traditional and Western Medicine 1998;18(12):727‐9. [MEDLINE: ] - PubMed
Lei FY 2001 {published data only}
    1. Lei FY. [38 cases of type II diabetes complicated with fatty liver by treatment of 'strengthening the spleen and removing turbid pathogen'] [in Chinese]. Hubei Journal of Traditional Chinese Medicine 2001;23(6):18.
Li M 1999 {published data only}
    1. Li M, Wang X. Clinical observation on treatment of diabetic peripheral neuropathy with reinforced Tianma Duzhong capsule. Journal of Traditional Chinese Medicine 1999;19(3):182‐4. [MEDLINE: ] - PubMed
Liang X 1999 {published data only}
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Liang XC 1989 {published data only}
    1. Liang XC, Guo SS, Qian ZF, Tao LH, Wang Y. [Effect of "Yiqi Yangyin Huoxue" Prescription on hemorrheology of diabetes with symptoms of "Qi, Yin" deficiency and stasis of blood] [in Chinese]. Acta Academiae Medicinae Sinicae 1989;11(2):87‐91. - PubMed
Liang Z 2001 {published data only}
    1. Liang Z. Treatment of 28 cases of type 2 diabetes by adding self‐prescribed herbal medicine Jiang Tang San [in Chinese]. Guangxi Journal of Traditional Chinese Medicine 2001;24(5):12‐3.
Liu B 2002 {published data only}
    1. Liu B, Ge SJ. [Clinical study on 235 cases of diabetes treated with integrated Chinese and western medicine] [in Chinese]. Forum on Traditional Chinese Medicine 2002;17(3):34‐5.
Liu CH 2002 {published data only}
    1. Liu CH, Zhao GW, Yi HY, Huang Y. [Observation on therapeutic effect of comprehensive therapy for treatment of 45 cases of type 2 diabetes] [in Chinese]. New Journal of Traditional Chinese Medicine 2002;34(5):30‐1.
Liu LL 2003 {published data only}
    1. Liu LL. [Clinical study on Xiaotangsan for treatment of type 2 diabetes mellitus] [in Chinese]. Shandong Journal of Traditional Chinese Medicine 2003;22(10):594‐6.
Liu QG 2000 {published data only}
    1. Liu QG, Chen XJ, Lu H, Liu J, Zhao HX, Cui F, et al. [Clinical study on effects of Jiangtang Dan on reducing blood glucose and activiating blood and removing stasis] [in Chinese]. Academic Periodical of Changchun College of Traditional Chinese Medicine 2000;16(4):12‐3.
Liu XL 2000 {published data only}
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Lu GD 2002 {published data only}
    1. Lu GD. [Observation on Rongshuan Ketang capsule for treatment of 43 patients with type 2 diabetes mellitus] [in Chinese]. Journal of Practical Traditional Chinese Medicine 2002;18(4):4‐5.
Luo J 1998 {published data only}
    1. Luo J, Fort DM, Carlson TJ, Noamesi BK, nii‐Amon‐Kotei D, King SR, et al. Cryptolepis sanguinolenta: an ethnobotanical approach to drug discovery and the isolation of a potentially useful new antihyperglycaemic agent. Diabetic Medicine 1998;15:367‐74. - PubMed
Ma Y 2002 {published data only}
    1. Ma Y, Wen SZ. [Study on therapeutic effect of herb Potentilla discolor for treatment of 50 cases of type 2 diabetes] [in Chinese]. Chinese Traditional and Herbal Drugs 2002;33(7):644.
Meckes‐Lozyoa 1986 {published data only}
    1. Meckes‐Lozyoa M, Roman‐Ramos R. Opuntia streptacantha: a coadjutor in the treatment of diabetes mellitus. The American journal of Chinese medicine 1986;14(3‐4):116‐8. - PubMed
Moshi 2001 {published data only}
    1. Moshi MJ, Lutale JJ, Rimoy GH, Abbas ZG, Josiah RM, Swai AB. The effect of Phyllanthus amarus aqueous extract on blood glucose in non‐insulin dependent diabetic patients. Phytotherapy Research 2001;15(7):577‐80. - PubMed
Niu ZY 2003 {published data only}
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Pan XC 2002 {published data only}
    1. Pan XC. [Study of self‐prescribed Xia Xiao Yin for treatment of 52 cases of type 2 diabetes mellitus] [in Chinese]. Guang Ming Journal Traditional Chinese Medicine 2002;17(3):36‐8.
Parikh 2001 {published data only}
    1. Parikh P, Mani U, Iyer U. Role of Spirulina in the control of glycemia and lipidemia in type 2 diabetes mellitus. Journal of Medicinal Food 2001;4(4):193‐9. - PubMed
Peng GR 2001 {published data only}
    1. Peng GR, Zhao B. [Clinical study on combination therapy of Xiaoketang and Glibenclamide for treatment of 92 cases of type 2 diabetes mellitus] [in Chinese]. Hunan Journal of Traditional Chinese Medicine 2001;17(2):17‐8.
Ren H 2000 {published data only}
    1. Ren H. A clinical study on treatment of diabetic peripheral neuropathy with Tang Zhi Min capsules. Journal of Traditional Chinese Medicine 2000;20(4):258‐61. [MEDLINE: ] - PubMed
Rodriguez‐Moran 1998 {published data only}
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Ryan 2000 {published data only}
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Sang Y 1996 {published data only}
    1. Sang Y, Wang XB, Han Q. [Effects of tangshenkang capsule on diabetic nephropathy] [in Chinese]. Chinese Journal of Integrated Traditional and Western Medicine 1996;16(7):398‐401. - PubMed
Sharma 1990 {published data only}
    1. Sharma RD, Raghuram TC. Hypoglycaemic effect of Fenugreek seeds in non‐insulin dependent diabetic subjects. Nutrition Research 1990;10:731‐9.
Sitprija 1987 {published data only}
    1. Sitprija S, Plengvidhya C, Kangkaya V, Bhuvapanich S, Tunkayoon M. Garlic and diabetes mellitus phase II clinical trial. Journal of Medical Association of Thailand 1987;70(Suppl 2):223‐7. - PubMed
Song SY 2003 {published data only}
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Sun YW 2002 {published data only}
    1. Sun YW, Yuan L. [Therapeutic study on 60 cases of dormant diabetes treated by Ziyin Jiangtang capsule] [in Chinese]. Research of Traditional Chinese Medicine 2002;18(4):9.
Velussi 1997 {published data only}
    1. Velussi M, Cernigoi AM, Monte AD, Dapas F, Caffau C, Zilli M. Long‐term (12 months) treatment with an anti‐oxidant drug (silymarin) is effective on hyperinsulinemia, exogenous insulin need and malondialdehyde levels in cirrhotic diabetic patients. Journal of Hepatology 1997;26:871‐9. - PubMed
Vuksan 2000 {published data only}
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Wang H 1997 {published data only}
    1. Wang H. [Clinical study of Chinese medicine for treatment of diabetes complicated with minor albumin urine] [in Chinese]. Guangdong Medical Journal 1997;18(4):259‐60.
Wang HL 2000 {published data only}
    1. Wang HL. [Clinical study on 62 cases of type 2 diabetes mellitus treated with integrated Chinese and western medicine] [in Chinese]. Beijing Journal of Traditional Chinese Medicine 2000;19(4):35‐6.
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Wang ZL 1990 {published data only}
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Wu S 2000 {published data only}
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Wu ST 2000 {published data only}
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Yan HH 2001 {published data only}
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Yan ZY 2001 {published data only}
    1. Yan ZY. [35 cases of diabetes treated with Shenling Baishu San combined with glibenclamide] [in Chinese]. Hunan Guiding Journal of Traditional Chinese Medicine and Pharmacology 2001;7(6):301‐3.
Yu H 2000 {published data only}
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Yu J 2001 {published data only}
    1. Yu J. [Clinical study on insulin resistence in patients with type 2 diabetes mellitus using Ge Gen Su] [in Chinese]. Shandong Journal of Traditional Chinese Medicine 2001;20(12):727‐9.
Yu JY 1995 {published data only}
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Zhang M 2001b {published data only}
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Zhang XD 2002 {published data only}
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Zhang XQ 2000 {published data only}
    1. Zhang XQ. [Combination therapy of Bushen Huaxue Tang with glibenclamide for treatment of 40 cases of type diabetes mellitus] [in Chinese]. Journal of Anhui Traditional Chinese Medicine College 2000;19(4):27‐8.
Zhao QL 2003 {published data only}
    1. Zhao QL, Guo BR, Yang WJ. [Tianqi Jiangtang capsule for treating 300 cases of type 2 diabetes] [in Chinese]. Journal of Shandong University of Traditional Chinese Medicine 2003;27(3):191‐2.
Zhong SC 2000 {published data only}
    1. Zhong SC. [Clinical observation on 64 cases of diabetes II with therapy of Spleen‐Kidney treatment] [in Chinese]. Hunan Journal of Traditional Chinese Medicine 2000;16(6):13‐4.
Zhou JH 2001b {published data only}
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Zhu L 1992 {published data only}
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Zhu LQ 1999 {published data only}
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Zhu LZ 1991 {published data only}
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